In Crisis Intervention Team (CIT) training, police officers participate in 40 hours of specialized training provided by local mental health professionals, family members/advocates, and mental health consumer groups. Upon completion of the training, these officers serve as specialized first-line responders for calls involving people with serious mental illnesses (SMI). The CIT model also supports partnerships between psychiatric emergency services and police departments, increasing the likelihood that people in psychiatric crisis will be taken to medical facilities rather than jails. The proposed study was developed in response to a prominent dearth of research on CIT, even though it is being implemented widely in numerous municipalities across the U.S. This research, which will build on the PI's ongoing CIT research, will examine the ways in which CIT training may ultimately lead to improved patient- and system-level outcomes by addressing the crucial issue of officer-level outcomes of CIT. This research will be a first step toward understanding how this collaborative model works and will set the stage for research that could have major implications for people with SMI who often interact with law enforcement/criminal justice systems. This project will compare CIT and non-CIT officers and test two complementary models of effects of CIT-the Theory of Planned Behavior (TPB) and the novel Model of Officer-Level Effects of CIT (MOLEC). The specific aims of the research are: Aim 1: To design, adapt, and study the psychometric properties (i.e., reliability, validity) of a number of measures developed specifically for use with police officers;Aim 2: To evaluate the utility of the TPB, the exploratory MOLEC model, and a combined model, in explaining intentions to facilitate mental health referrals and de-escalation skills of 250 CIT vs. 250 non-CIT officers;and Aim 3: To examine the effectiveness of the CIT program in facilitating actual mental health referrals by comparing reports of encounters with individuals with suspected SMI and appropriateness of referrals in CIT vs. non-CIT officers over 6 weeks. Months 1-6 will be dedicated to careful instrument development/adaptation, engagement of police departments, preparation for recruitment and data collection, and testing of instrument reliability/validity. Months 7-30 will include in-depth cross-sectional and 6- week longitudinal data collection, database development, and data entry. Months 31-36 will involve data analysis and dissemination of findings to various relevant audiences. Ultimately, this research may elucidate how the mental health and law enforcement communities can collaborate to improve the health of individuals living with SMI by reducing criminalization and enhancing access to mental health services. PUBLIC HEALTH RELEVANCE: The public health importance of the proposed research is substantial given the nationwide problem of criminalization of mental illnesses resulting in incarceration of people with serious mental illnesses for minor infractions, which delays or precludes the provision of recovery-oriented mental health services. By studying officer-level effects of Crisis Intervention Team (CIT) training, collaborations between law enforcement and mental health can be enhanced and people with serious mental illnesses may be able to lead safer, healthier lives supported by mental health treatment services rather than being entangled in the criminal justice system.